Phase three – WORKING TOGETHER FOR HEALTH AND DEVELOPMENT AQUIRING SKILLS AND COMPETENCE – LEARNING BY DOING

PROMOTE HEALTH AWARENESS

There is much in common between the factors or conditions that determine health and development. Behavioural factors, life styles, account for about half of all ill health, whilst attitudes to life and work play a significant role in socio economic development. A functional components of individual household and community health care can be the basis for major health improvements is being used as a checklist for action plans in local communities.


A healthy district is the only mathematically possible location where community participation, inter sectoral collaboration, affordable technologies (pillars of the Alma Ata Declaration) can be simultaneously applied. It is therefore accepted as the operational unit for primary health care.

Certain local structures – health and development committees, health teams and community health associations are excellent vehicles for the promotion of community health awareness.


ENCOURAGE COMMUNITY OWNERSHIP

Local communities, demonstrably the actors and the principal beneficiaries of local health care, include village, neighbourhood, education, workplace, faith based, socially, economically and professionally linked communities.

Community organizations have adopted a participatory approach to development, from participation to empowerment and finally “ownership”

Residents collaborate with visiting experts bringing leadership skills, offer professional advice and financial support. Experts (humanities) would help with mobilization, communication and organization; experts (science) would provide technical advice, technical training and technical work.

Ownership by local communities is encouraged by their local and regional levels, serving as a link between communities and central authority.


SHARING ROLES AND RESPONSIBILITY

A hierarchy of responsibilities – programme directions,, programme operations and operational activities – are allocated respectively to District Development Committees, District Health Office and District Health Teams.

Health committees would participate in supportive supervision, collection and use of health information, health education/literacy, cooperation with other sectoral agents, and resource mobilization.

There is coordination of the activities of health teams, community health associations and health committees.

The profile of the district health team is established with improvements in human, material and financial resources. It includes Team Leaders, Basic Health Care and Technical support functions.


MOBILIZATION OF FUNDS FOR HEALTH AND DEVELOPMENT

The journey to National Health Insurance starts with identifying obstacles, and overcoming these through community efforts – collective savings from poor households, health risk sharing in local mutual funds and regional “group insurance” arrangements.

Mobilization of funds – community health association’s funds in health areas, mutual health funds in health districts, solidarity health funds in regions and centre.

Increasing health risk coverage is established – primary, secondary and tertiary health care in health areas, health districts and regions respectively; sanitary evacuation, epidemics and emergencies are covered at the national level.

Health Insurance has become a reality since preliminary and follow-up activities are organized nationwide; whilst the necessary mobilization and funds creation continues at community, local and regional levels respectively.


MEETING HEALTH AND DEVELOPMENT CHALLENGES

A community health package is the centre piece of these challenges. It is associated with educational, management and research support, as well as adequate resources. This health care is being assured in the wider context of the major health determinants – life styles, population, biology, environmental management and health care services.

An integrated health development matrix provides a framework for planning and follow up for; relating management improvements to resources and technologies and health millennium targets.

Health and development activities are being organized together at the local level. Health committees catalyze the production of healthy people who will, with the guidance of development committees, generate wealth which also result in better health.


IMPLEMENTING HEALTH DEVELOPMENT PACKAGES

The broad goals and major thrusts in health development are incorporated in local hospital based curative care for individuals, health centre based health promotion for households and other community based activities and economic, social and cultural.

The elements of a viable district are visible; they include the structures of governance, the district health services (hospital, public health, and related sectors) as well as community initiatives. Ensuring that health districts are viable is a major goal of the healthy communities movement.

The community health care package clearly includes individual curative care, household health promotion and neighbourhood disease prevention. Each of these has composants – items and targets; which facilitates a holistic approach.

The package would also include community health interventions in response to specific problems targeted for elimination, overcoming endemo-epidemic diseases, and squarely facing priority problems including HIV/AIDS, resolving funds, emergency preparedness.


PROGRESS TOWARDS THE MILLENNIUM GOALS

Reduce child mortality improve maternal health, combat HIV/AIDS etc fall squarely on the health sector (MDG4,5,6), achieve universal primary education, promote gender equality (MDG2,3) have important health implementations; eradicate extreme poverty, ensure environmental sustainability, develop a global partnership (MDG1,7,8) are prerequisites for achievement of the health goals.

The eight millennium development goals are complementary to the eight primary health care (Alma Ata) elements. To accelerate and monitor progress, relevant themes for MDG’s 4, 5 and 6 are presented; they relate to fundamental community health indicators – child survival, safe motherhood, health workforce.

Universities are reservoirs of national expertise and youthful energy. The core faculties (Arts and Science) can provide institutional support and technology transfer (MDG8). Education and Mass Communication faculties can contribute to MDG’s 2 and 3. Agriculture, Commerce, and Management faculties can contribute to MDG1. Faculties of Engineering and Technologies for MDG7, Medicine and Health Sciences for MDG’s 4, 5, 6. Tapping this national reservoir will accelerate development.

Monitoring progress in the following areas will also cover the millennium goals. These are human development, basic education, acquired skills, stable employment; human settlements – energy supplies, food supplies, water supplies; human populations – healthy housing , healthy schools, healthy workplaces.